Cochrane Db Syst Rev
-
Cochrane Db Syst Rev · Jul 2005
Review Meta AnalysisIntravenous secretin for autism spectrum disorder.
Secretin is a gastro-intestinal hormone which has been presented as an effective treatment for autism based on anecdotal evidence. ⋯ There is no evidence that single or multiple dose intravenous secretin is effective and as such it should not currently be recommended or administered as a treatment for autism. Further experimental assessment of secretin's effectiveness for autism can only be justified if methodological problems of existing research can be overcome.
-
Cochrane Db Syst Rev · Jul 2005
Review Meta Analysis Comparative StudyHospital at home versus in-patient hospital care.
Hospital at home is defined as a service that provides active treatment by health care professionals, in the patient's home, of a condition that otherwise would require acute hospital in-patient care, always for a limited period. ⋯ Despite increasing interest in the potential of hospital at home services as a cheaper alternative to in-patient care, this review provides insufficient objective evidence of economic benefit. Early discharge schemes for patients recovering from elective surgery and elderly patients with a medical condition may have a place in reducing the pressure on acute hospital beds, providing the views of the carers are taken into account. For these clinical groups hospital length of stay is reduced, although this is offset by the provision of hospital at home. Future primary research should focus on rigorous evaluations of admission avoidance schemes and standards for original research should aim at assisting future meta-analyses of individual patient data from these and future trials.
-
Cochrane Db Syst Rev · Jul 2005
Review Meta AnalysisMultiple versus single lumen umbilical venous catheters for newborn infants.
Multiple lumen umbilical venous catheters (ML-UVCs) instead of single lumen UVCs (SL-UVCs) may decrease the need for additional venous lines. Although it seems self-evident that ML-UVCs would reduce the need of additional venous lines, the rates of associated complications might be different. ⋯ The use of ML-UVCs in comparison to SL-UVCs in neonates is associated with decrease in the usage of PIVs in first week of life, but an increase in catheter malfunctions. As the quality of included randomized studies is poor and the estimates of clinically important complications are imprecise, no firm recommendations can be made regarding the choice of UVC. Adequately powered, properly randomized and properly blinded controlled trials are needed that address the effectiveness and safety of ML-UVCs (double and triple lumen) in comparison to SL-UVCs. These studies should also address the impact of type of catheter material.
-
Cochrane Db Syst Rev · Jul 2005
Review Meta AnalysisTraditional suburethral sling operations for urinary incontinence in women.
Traditional suburethral slings are surgical operations used to treat women with symptoms of stress urinary incontinence. ⋯ The data on sub urethral sling operations remain too few to address the effects of this type of surgical treatment. Few trials are reported by authors in a complete fashion and most information came from abstracts presented in annual meetings. The broader effects of suburethral slings could not be established since trials did not include appropriate outcome measures such as general health status, health economics, pad testing, third party analysis and time to return to normal activity level. Data obtained from thirteen trials did not provide reliable estimates because of their sizes, and heterogeneity of designs, populations studied, and types of comparisons made. Reliable evidence on which to judge whether or not suburethral slings are better or worse than other surgical or conservative management is currently not available.
-
Cochrane Db Syst Rev · Jul 2005
Review Meta AnalysisFrequency of administration of recombinant human erythropoietin for anaemia of end-stage renal disease in dialysis patients.
The benefits of recombinant human erythropoietin (rHuEPO) administration in dialysis patients have been demonstrated, however the optimal frequency regimen have yet to be established. ⋯ There is no significant difference between once weekly versus thrice weekly subcutaneous administration of rHuEPO. Once weekly administration would require an additional 12 U/kg/wk for patients on haemodialysis, however this is based on one very small study. Cost of additional rHuEPO needs to assessed with regard to patient preference and compliance.